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20-11-2023 | Computed Tomography | Research

Clockwise versus counterclockwise rotation in bimaxillary surgery: 3D analysis of facial soft tissue outcomes

Authors: Yi-Hsuan Chen, Frank Baan, Robin Bruggink, Ellen Wen-Ching Ko, Stefaan Bergé, Tong Xi

Published in: Oral and Maxillofacial Surgery

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Abstract

Purpose

This study aimed to compare facial 3D soft tissue changes in subjects with Class III deformities who underwent bimaxillary clockwise (CW) and counterclockwise (CCW) rotational orthognathic surgery.

Methods

Asian Class III subjects who completed bimaxillary surgical orthodontic treatments were enrolled and categorized into CW and CCW groups based on maxillary occlusal plane alterations. Preoperative and 9-month follow-up cone-beam computed tomography (CBCT) and 3D stereophotogrammetry were obtained, superimposed, and quantified for skeletal movements and soft tissue changes in six facial regions. Inverse probability of treatment weighting (IPTW) adjusted for potential confounding factors.

Results

Thirty-seven subjects were included (CW group, n = 20; CCW group, n = 17). Postsurgical chin volume significantly reduced in the CW group compared to the CCW group (mean difference 6362 mm3; p = 0.037), and intergonial width significantly decreased in the CW group (mean difference 6.2 mm; p = 0.005). The postoperative alar width increased by 1.04 mm and 1.22 mm in the CW and CCW groups, respectively (p = 0.70). However, these changes were not significantly correlated to the direction of MMC pitch.

Conclusion

Clockwise rotation of the bimaxillary complex demonstrated a significant advantage in reducing chin volume and intergonial width compared to counterclockwise rotation, leading to a reduced frontal lower face width among Asian Class III subjects.
Literature
1.
go back to reference Bailey LT, Proffit WR, White RP Jr (1995) Trends in surgical treatment of Class III skeletal relationships. Int J Adult Orthodon Orthognath Surg 10:108–118PubMed Bailey LT, Proffit WR, White RP Jr (1995) Trends in surgical treatment of Class III skeletal relationships. Int J Adult Orthodon Orthognath Surg 10:108–118PubMed
4.
go back to reference Wolford LM, Dugan DJ, Hilliard FW (1985) Surgical treatment objective: a systematic approach to the prediction tracing. Part I. CV Mosby Wolford LM, Dugan DJ, Hilliard FW (1985) Surgical treatment objective: a systematic approach to the prediction tracing. Part I. CV Mosby
13.
go back to reference Swennen GR, Schutyser FA, Hausamen JE (2005) Three-dimensional cephalometry: a color atlas and manual. Springer Science & Business Media Swennen GR, Schutyser FA, Hausamen JE (2005) Three-dimensional cephalometry: a color atlas and manual. Springer Science & Business Media
24.
go back to reference Hunsuck EE (1968) A modified intraoral sagittal splitting technic for correction of mandibular prognathism. J Oral Surg 26:250–253PubMed Hunsuck EE (1968) A modified intraoral sagittal splitting technic for correction of mandibular prognathism. J Oral Surg 26:250–253PubMed
25.
go back to reference Epker BN (1977) Modifications in the sagittal osteotomy of the mandible. J Oral Surg 35:157–159PubMed Epker BN (1977) Modifications in the sagittal osteotomy of the mandible. J Oral Surg 35:157–159PubMed
32.
go back to reference Zhu M, Xie Y, Zhu Y, Chai G, Li Q (2016) A novel noninvasive three-dimensional volumetric analysis for fat-graft survival in facial recontouring using the 3L and 3M technique. J Plast Reconstr Aesthet Surg 69:248–254CrossRefPubMed Zhu M, Xie Y, Zhu Y, Chai G, Li Q (2016) A novel noninvasive three-dimensional volumetric analysis for fat-graft survival in facial recontouring using the 3L and 3M technique. J Plast Reconstr Aesthet Surg 69:248–254CrossRefPubMed
40.
go back to reference Jafarian M, Alam M, Shafiei S, Moslemi H, Tabrizi R (2020) Effect of fixation method on intergonial width stability after mandibular setback via bilateral sagittal split osteotomy. Int J Oral Maxillofac Surg 49:1430–1434CrossRefPubMed Jafarian M, Alam M, Shafiei S, Moslemi H, Tabrizi R (2020) Effect of fixation method on intergonial width stability after mandibular setback via bilateral sagittal split osteotomy. Int J Oral Maxillofac Surg 49:1430–1434CrossRefPubMed
Metadata
Title
Clockwise versus counterclockwise rotation in bimaxillary surgery: 3D analysis of facial soft tissue outcomes
Authors
Yi-Hsuan Chen
Frank Baan
Robin Bruggink
Ellen Wen-Ching Ko
Stefaan Bergé
Tong Xi
Publication date
20-11-2023
Publisher
Springer Berlin Heidelberg
Published in
Oral and Maxillofacial Surgery
Print ISSN: 1865-1550
Electronic ISSN: 1865-1569
DOI
https://doi.org/10.1007/s10006-023-01196-w